For four to five hours, he sits, facing a window overlooking a sprawling field, as his blood runs through tubes, in and out of a dialysis machine.

It's doing what his kidneys can't -- filtering his blood.

Although Mr. Ramsey has known for a few years he might need dialysis, when he was told late last year that he'd need to start receiving treatments, him and his wife, Sue, prepared to make some lifestyle changes.

The couple sold their horse farm nearly five years ago, but their lives haven't slowed down. Mr. Ramsey is currently helping another local couple set up a farm of their own, and Mrs. Ramsey has put together several books about her family history, her time with her husband, and coveted family recipes.

Together, they've also traveled the world.

But with Mr. Ramsey's good health now dependent on a dialysis machine, the couple envisioned spending a good portion of their week in the hospital.

"We thought that was pretty much it," says Mrs. Ramsey. "It hardly was."

Shortly after Mr. Ramsey started dialysis treatment, he was told he was a candidate for home-based treatment, but he and his wife would need to learn the how to use the machine.

"There's no way I thought I was going to be able to do it," says Mr. Ramsey.

After an eight-week course and approximately three months of training in total, both he and his wife became certified for home hemodialysis.

Before every treatment, Mr. Ramsey and his wife take the machine through a series of tests, recording data, calibrating systems and following step-by-step instructions to provide Mr. Ramsey with the exact care he needs.

The couple also follows a strict maintenance schedule, which involves checking, changing, and disinfecting parts, as well as an ordering schedule, to ensure they have enough supplies.

"It's not a minor affair," says Mrs. Ramsey.

Once every month, Mr. Ramsey uses the machine to take blood, and brings it to a lab for testing. When necessary, the couple uses another machine to separate red and white blood cells before it's tested.

While home hemodialysis is possible without a spouse or helper, Mr. Ramsey says he appreciates having his wife there to help him through the process.

"It's like flying," he says. "Two pilots can do a much safer job than one."

"You can counter-check each other," his wife adds.

The couple, who are used to working as team both in the air and on land, speak from experience.

Shortly after Mr. Ramsey turned 50, he and his wife learned to pilot two-seater planes, and they've flown 4,000 hours together since.

Originally, the duo figured dialysis would put a damper on their now bi-annual trips to Florida, but Kate Brown, a dialysis nurse for the home hemodialysis program, has helped Mr. Ramsey co-ordinate treatments at a Florida clinic while he travels.

"Kate has just been so phenomenal is helping us with all of that," says Mrs. Ramsey, noting Ms Brown also works hard to boost moral among her patients.

The home hemodialysis program turned a year old in Peterborough last month. Ms Brown, who initially set up the program, says it took close to seven years to apply and receive approval to begin offering home services.

"It takes a long time for money to change hands," she says. "And there's a lot of bureaucratic red tape to get through."

Approximately 150 patients receive hemodialysis at the hospital in Peterborough.

Ms Brown says she'd hope to set eight dialysis patients up at home within the first year. She recently signed up her 11th patient and hopes to see another 10 receive treatments at home within another year.

Having the treatment at home, as opposed to visiting a dialysis centre for four hours three times every week, means the patients can spend more time on the machines, for optimal care, she says.

Patients also have the option to organize their treatment times to suit their lifestyle, possibly choosing to have shorter treatments more often, or longer treatments less often. Cancelling a treatment also becomes less of a hassle.

"The hospital has so many people that get treatment," says Mr. Ramsey, noting when a patient shows up late or misses an appointment, it throws off the schedule for others who are waiting for their time on the machines. "They have to be able to fit them all in."

Normally, Mr. Ramsey has his treatment Monday, Tuesday, Thursday and Friday. But if something comes up, he can bump any of the treatments to a different day.

"(Dialysis) is something you don't look forward to," says Mr. Ramsey. "But if you have to do it, this is the best way."

Ms Brown says she approaches dialysis patients already coming for treatments about the program and makes sure every new patient is informed it's an option.

For some, though, it's intimidating.

"One man I'm training previously told me there was no way he would do it," she says, noting the man said he wasn't good with computers. "But he's doing it. Looking at him now, he's operating a $2,300 computer called a dialysis machine."

The machines meant for home care are simplified on the outside for easier use, but provide the same care patients receive in the hospital. Throughout the treatment cycle, patients are required to read the machine monitor to track their heart rate, blood pressure and the blood pumping speed among other numbers.

If there's a problem with the machine or patients have any questions, there's a 24-hour support system available over the phone, and nurses and technicians on-call to help out in-person if needed.

Ms Brown says there are special plumbing and electricity requirements for the machines, but the program budget helps to offset the costs of any modifications to the home.

Whether patients choose to participate in the program is a decision made based on personal preference and staff expertise.

"It's not right for everyone," says Ms Brown. "It all depends on who wants to go home, how well they are and if it's right for them. We can't control that."

After his treatment on a sunny Thursday morning, Mr. Ramsey plans to head out to the farm. He says he's thankful he still has his freedom despite the poor shape his kidneys are in.

"The flexibility of doing this at home is just fantastic," he says. "You can arrange your life without being a slave to the machine."

...